Abstract: The relationship between disease and good health has received relatively little attention in mental health. Resilience can be viewed as a defence mechanism, which enables people to thrive in the face of adversity and improving resilience may be an important target for treatment and prophylaxis. Though resilience is a widely-used concept, studies vary substantially in their definition, and measurement. Above all, there is no common underlying theoretical construct to this very heterogeneous research which makes the evaluation and comparison of findings extremely difficult. Furthermore, the varying multi-disciplinary approaches preclude meta-analysis, so that clarification of research in this area must proceed firstly by conceptual unification. We attempt to collate and classify the available research around a multi-level biopsychosocial model, theoretically and semiotically comparable to that used in describing the complex chain of events related to host resistance in infectious disease. Using this underlying construct we attempt to reorganize current knowledge around a unitary concept in order to clarify and indicate potential intervention points for increasing resilience and positive mental health.
Abstract: Recent studies suggest that ruminative thoughts may be mediators of the prolonged physiological effects of stress. We hypothesized that autonomic dysregulation plays a role in the relation between rumination and health. Rumination was induced by an anger-recall task in 45 healthy subjects. Heart rate variability (HRV), baroreflex sensitivity (BRS), and baroreflex effectiveness index (BEI) change scores were evaluated to obtain the autonomic phenotype of rumination. Personality traits and endothelial activation were examined for their relation to autonomic responses during rumination. Degree of endothelial activation was assessed by circulating soluble intercellular adhesion molecule-1 (sICAM-1). Vagal withdrawal during rumination was greater for women than men. Larger decreases in the high frequency component of HRV were associated with higher levels of anger-in, depression, and sICAM-1 levels. BRS reactivity was negatively related to trait anxiety. BEI reactivity was positively related to anger-in, hostility, anxiety, and depression. Lower BEI and BRS recovery were associated with lower social desirability and higher anger-out, anxiety, and depression. Findings suggest that the autonomic dysregulation that characterizes rumination plays a role in the relationships between personality and cardiovascular health.
Abstract: Effects of psychological traits on heart rate (HR) and heart rate variability (HRV) were evaluated in patients awaiting cardiac surgery. Alexithymics demonstrated slowed HR, whereas high cognitive performance was associated with elevated HR in 2-3 days before surgery. Depression negatively correlated with HRV low frequency power. These data are consistent with previous findings of diverse moderate stress effects on HR regulation in cardiologic patients and healthy subjects in accordance to differences in psychological characteristics.
Abstract: BACKGROUND: The aim of the study was to determine the effects of asymmetric cerebral embolic load on cognitive functions. METHODS: Thirty-six open heart surgery (OH) and 26 coronary artery bypass grafting (CABG) patients were evaluated by neuropsychological and transcranial Doppler tests. RESULTS: OH was associated with a significantly larger microembolic load in comparison to CABG. In OH patients, the microembolic load at the left middle cerebral artery correlated with a verbal memory decline, whereas the microembolic load at the right middle cerebral artery correlated with a nonverbal memory deficit. CABG patients also showed a postoperative verbal memory decline which correlated with cardiopulmonary bypass length but not with microembolic load. CONCLUSION: Massive microembolic load during OH induces specific cognitive impairment in accordance to the brain region to which they are delivered. In atherosclerotic patients, the left temporal region is especially prone to perioperative ischemia.
Abstract: OBJECTIVE: This study examined women's mood responsiveness associated with patterns of stress hormone levels in everyday situations. METHODS: Self-reports of negative, positive, and energy dimensions of mood were obtained from 203 nurses throughout the day on a workday and on an off-work day during the luteal and follicular phases of the menstrual cycle. Individual differences in daytime norepinephrine and cortisol were assessed. RESULTS: Patterns of norepinephrine and cortisol levels were associated with ratings of the following moods: tired, sad, and happy. Phase of the menstrual cycle and the day factor (workday, off-work day) modified the association of mood ratings and stress hormone patterns. CONCLUSION: The experience of negative mood is associated with both hypoarousal and hyperarousal conditions. A homeostatic arousal-related concept of mood regulation is discussed.
Abstract: BACKGROUND: Recent studies have shown that depressive disorder is associated with impaired baroreceptor or baroreflex sensitivity, which is proposed to be a predisposing factor for sudden death in patients with manifest cardiac disease. These studies have not evaluated the afferent and efferent components of the cardiac baroreflex loop or other baroreflex mechanisms that regulate target processes (cardiac metabolism and blood pressure variability) related to the impairment. The objective of this study was to gain more insight into autonomic functioning in depressive disorder to more fully examine the potential basis for increased cardiac mortality. METHODS: The subjects were 28 women and men with unipolar major depression who were taking antidepressant medications and who were in partial remission and free of cardiovascular or other serious disease, and 28 healthy control subjects matched for sex, age, and ethnicity. The two samples were compared for negative affective dispositions (anger expression, hostility, defensiveness, anxiety), spontaneous (closed-loop) baroreflex activity, heart rate, heart rate variability, systolic blood pressure, and heart rate-systolic blood pressure double product under resting conditions. RESULTS: Depressed patients showed a general disposition to anger suppression coupled with higher hostility and anxiety, and lower defensiveness. The patients showed higher general sympathetic activity (high levels of blood pressure, low-frequency heart rate variability) and lower parasympathetic-related activity (high heart rate and reduced high frequency heart rate variability) with affected cardiac metabolism estimated by the double product. Depressed patients had lower baroreflex sensitivity related to a higher gain of the afferent component of the baroreflex without respective gain adjustment of its efferent component (reflex gain 'de-afferentation'). It was coupled with a compensatory higher number of effective baroreflex reactions (reflex gating 're-afferentation'). Antidepressant agents and depressed mood had additional independent effects on baroreflex sensitivity through the efferent component of the cardiac baroreflex loop. CONCLUSIONS: The data indicate that different baroreflex components and mechanisms may be impaired in patients with depression and may contribute to their increased cardiac risk.
Abstract: Preliminary findings support the potential of yoga as a complementary treatment of depressed patients who are taking anti-depressant medications but who are only in partial remission. The purpose of this article is to present further data on the intervention, focusing on individual differences in psychological, emotional and biological processes affecting treatment outcome. Twenty-seven women and 10 men were enrolled in the study, of whom 17 completed the intervention and pre- and post-intervention assessment data. The intervention consisted of 20 classes led by senior Iyengar yoga teachers, in three courses of 20 yoga classes each. All participants were diagnosed with unipolar major depression in partial remission. Psychological and biological characteristics were assessed pre- and post-intervention, and participants rated their mood states before and after each class. Significant reductions were shown for depression, anger, anxiety, neurotic symptoms and low frequency heart rate variability in the 17 completers. Eleven out of these completers achieved remission levels post-intervention. Participants who remitted differed from the non-remitters at intake on several traits and on physiological measures indicative of a greater capacity for emotional regulation. Moods improved from before to after the yoga classes. Yoga appears to be a promising intervention for depression; it is cost-effective and easy to implement. It produces many beneficial emotional, psychological and biological effects, as supported by observations in this study. The physiological methods are especially useful as they provide objective markers of the processes and effectiveness of treatment. These observations may help guide further clinical application of yoga in depression and other mental health disorders, and future research on the processes and mechanisms.
Abstract: It was recently shown that cognitive functions requiring more widespread brain integration relate to slower EEG activity, whereas cognitive performance supported by local brain integration is associated with faster EEG components (Von Stein & Sarnthein, 2000). Associations were studied between performance on WAIS and resting EEG spectral parameters in heroin abusers and normal young males. The most prominent associations between WAIS and EEG variables were consistently registered in polar and lateral frontal/temporal derivations. WAIS subtests predominantly loading on retrieval from long-term memory stores were significantly associated with delta bands mean frequencies. Subtests with strong working memory component related to theta2 mean frequency at temporal leads. Subtests requiring problem-solving operations correlated with alpha bands parameters, whereas psychomotor speed was associated with beta power. The data are in agreement with the hypothesis of Von Stein & Sarnthein (2000).
Abstract: Neuropsychological studies of cognitive dysfunction in attention deficit/hyperactivity disorder (ADHD) were analyzed. Three components in the spectrum of cognitive deficit in ADHD patients were obtained (primary deficit of sustained attention; secondary decline of intelligence and other cognitive functions; and cognitive deficit associated with co-morbidity). New literature data on possible role of cognitive dysfunction in high risk of alcohol and drug addictions formation are also presented.
Abstract: OBJECTIVE: This study examined women's mood responsiveness on work and off days during different phases of the menstrual cycle. METHODS: Self-reports of negative, positive, and energy dimensions of mood were obtained throughout the day on two work and two off days during the luteal and follicular phases of the menstrual cycle in 203 women nurses. Individual differences in daytime and nighttime epinephrine, norepinephrine, and cortisol were assessed. RESULTS: High daytime norepinephrine, epinephrine, and cortisol levels were associated with higher ratings of stress and tired, and with lower ratings of happy. The phase of the menstrual cycle and the day factor (workday, off day) were also associated with mood differences, and the direction of the effects depended on hormone levels and hormone sampling period. CONCLUSION: The experience of moods is affected by the arousal-related interaction of hormone levels with the phase of the menstrual cycle and occupational stress.
Abstract: Patients who underwent cardiac surgery and their relatives often complain on postoperative memory impairment. Most prospective neuropsychological studies also found postoperative cognitive decline early after surgery. Nevertheless, recently several reports questioned the existence of long-term brain alterations in these patient cohorts. The present review was aimed to clear up the true cardiac surgery effects on brain and cognitive functions. The reviewed data evidence that cardiac surgery interventions induce persistent localized brain ischemic lesions along with rapidly reversing global brain swelling and decreased metabolism. A range of studies showed that left temporal region was especially prone to perioperative ischemic injury, and these findings might explain persistent verbal short-term memory decline in a considerable proportion of cardiac surgery patient cohorts. Speed/time of cognitive performance is commonly decreased early after on-pump surgery either. Nevertheless, no association between psychomotor speed slowing and intraoperative embolic load was found. The rapid recovery of the latter cognitive domain might be better explained by surgery related acute global brain metabolism changes rather than ischemic injury effects. Hence, analyses of performance on separate cognitive tests rather than summarized cognitive indexes are strongly recommended for future neuropsychological studies of cardiac surgery outcomes.
Abstract: This review of the neuropsychological investigations of the drug abusers and high risk of drug abuse populations includes the widely recognized concepts of interactions between cognitive disturbances and drug addiction, and the results of the most recent studies in this field.
Abstract: OBJECTIVE: This study examined women's moods on work and off days during different phases of the menstrual cycle. METHOD: Self-reports of the moods angry, happy, sad, stressed, tired, and anxious were obtained on two work and two off days during the luteal and follicular phases of the menstrual cycle in 203 nurses. Individual differences in anger expression, anxiety, and hostility were assessed. RESULTS: Ratings of anxious, stressed, and tired were higher and happy and sad were lower on the workday than the off day. Menstrual cycle phase was associated with mood differences depending on the day (work, off work) and individual differences in personality traits. CONCLUSIONS: The experience of moods in everyday life is affected by overall levels of stress and phase of the menstrual cycle. The findings suggest the need to refine sociopsychobiological and clinical models of mood regulation and of risk for disease.
Abstract: Planning function deficit is the most consistent finding in neuropsychological studies of heroin addicts. The performance on the Tower of London Test (TLT) correlated with the duration of daily heroin abuse (DDHA) in our previous study. Alpha2 mean frequency in anterior/central derivations was also predicted by DDHA in the same patient population. This retrospective study was undertaken in order to understand better the relationships between observed neurological deviations in heroin abusers. Thirty-three heroin addicts and 12 healthy males were evaluated with 14 neuropsychological tests and resting eyes-closed electroencephalography (EEG). Multivariate tests showed that performance on the difficult (five-move) problems of TLT was strongly predicted by the EEG alpha2 mean frequency shifts, and these relationships were generally mediated by chronic heroin length. However, post-hoc analyses at separate leads demonstrated that the relationships between cognitive variables and alpha2 mean frequencies in the left hemisphere were independent of chronic heroin effects, whereas elevation of alpha2 frequency in the right hemisphere was strongly predicted by chronic heroin intake length. The patients with extremely high alpha2 mean frequency at the left central region were especially prone to failure in TLT due to the inability of the hypothesized alpha2-generating network, which normally projects to the central and temporal derivations bilaterally and to the right posterior temporal derivation to function appropriately. Hence, it was concluded that planning dysfunction in heroin abusers is related to alpha2 mean frequency shifts predominantly at the central regions.
Abstract: The purpose of the present study was to investigate cumulative heroin effects on brain functioning by studying relationships among electroencephalography (EEG) spectral power and mean frequencies and heroin abuse history. Eyes-closed resting EEG data were collected from the 19 monopolar electrode sites in 33 heroin abusers and 13 age-matched healthy volunteers. The mean age of the patients was 23.1+/-4.5 years, the duration of daily heroin abuse (DDHA) ranged from 4 to 44 months, the intravenous doses of heroin ranged from 0.04 to 1.00 g/day, the abstinence length ranged from 6 days to 4.5 months. General linear model (GLM) repeated measures procedure revealed a significant group effect on the distribution of the mean power spectrum between bands and mean frequencies in almost all analyzed derivations. Further analysis demonstrated that these intergroup differences were diversely related to at least three aspects of heroin-taking history. Frequency shifts in alpha2 range, most prominent in frontal and central derivations, were related to duration of daily heroin consumption. Slowing of alpha1 mean frequency, most prominent in central, temporal, and occipital derivations, was registered mainly in heroin addicts who abused high doses of the drug. Spectral power characteristics of brain electrical activities in our patient population were strongly predicted by abstinence length. The present results give grounds to suppose that chronic heroin-taking induces neuronal oscillation frequency changes, which may contribute to the development of antisocial trends and some semantic processes disturbances in these patients. Supplementary neurophysiological deficit is characteristic for heroin addicts who takes high doses of the drug, however, its relation to heroin abuse remains unclear. Pronounced desynchronization is observed in acute heroin withdrawal, and spectral power characteristics tend to normalize almost completely during several weeks of abstinence.
Abstract: Standard 19-channel EEG registration was performed in 30 heroin addicts (mean age 21.7 +/- 2.8 years, daily heroin abusing duration--12.2 +/- 8.0 months, heroin dose per day--0.42 +/- 0.29 g, abstinence duration--12.3 +/- 8.1 days). Qualitative EEG changes, being observed in more than 70% of the cases, included low voltage of background activity with depression of alpha rhythm and increase in beta activity; large amount of low amplitude waves in central regions; low reactivity to stimulation. The patients with daily heroin doses more than 0.5 g demonstrated slowing of alpha rhythm in comparison to those with lower doses (8.9 +/- 0.8 Hz vs 10.3 +/- 2.0 Hz, p < 0.05). In follow-up study, obvious or even complete normalization of the EEG was observed in most of the cases during the first months of abstinence.
Abstract: On 4 days, in everyday situations, 21 female and 26 male smokers used an electronic diary to record situations and moods at times of smoking and at control nonsmoking occasions. Self-reports of particular locations, activities, posture, consumption, social context, moods, and internal states were specifically associated with smoking. Real-time assessments in everyday situations provide useful information about the interplay of environmental factors and internal states in smoking. The findings suggest that conditioning and learning processes play a role in smoking and should be considered in smoking cessation programs.
Abstract: Heroin abusers who performed two "prefrontal" psychological tests (WCST and Delayed Alternation test--DIAT) with unusual amount of perseverative responses, reached i.v. doses of 0.5-1.0 g of heroin per day during the first year of heroin intake and continued out-patient treatment after discharge from hospital. Patients with "ideal" performance on two tests injected 0.1-0.3 g of heroin per day during the first year of heroin intake and stopped treatment after discharge, sometimes returned for treatment after several months of remission because of relapse. The latter patient group had lower verbal intelligence in comparison with education-matched normal controls. Percent of normal controls who made unusually many perseverative responses on WCST was the same as in the patient group (chi 2 = 5.5, p = 0.24). CONCLUSIONS: a) Performance of WCST and partially DAT can characterise of premorbid psychological status in heroin abusers; b) premorbid dysfunction of prefrontal cortex that mediates perseverative responses to WCST and DAT may contribute to drug abusing severity; c) low verbal intelligence may poorly influence treatment compliance in heroin abusers.
Abstract: Neurological consequences of chronic heroin exposure are poorly known. 38 male patients with current heroin abuse or dependence were examined in withdrawal period that lasted more than 10 days, and were compared with 19 healthy controls. Wisconsin Card Sorting Test (WCST), "Delayed Alternation" Test (DAT), "Tower of London" Test (TLT), Russian version of WAIS (1995) were used. Patients were medicated and medication status was evaluated by psychomotor speed level. Patients with the duration of daily heroin abuse more than 1.5 years performed significantly less effectively TLT solutions as compared with the healthy controls (after Bonferroni correction, p = 0001). Patients with shorter duration of daily heroin abuse had a trend to perform TLT solutions poorer as compared to healthy controls and better than group with longer duration (after Bonferroni correction, p = 0.07 and 0.08). Three groups did not differ by WCST and DAT significantly, and general intelligence was in normal range in three groups. Multiple regression analysis confirmed significant influence of daily heroin abuse duration on TLT performance efficiency in our population (beta = -0.426, p < 0.05) without effect of age, education, IQ, dosage of heroin per day, withdrawal duration and current medication status (psychomotor speed level). Perseverative responses on DAT were significantly related to daily heroin dosages before treatment (beta = 0.405, p < 0.05) and negatively correlated with the withdrawal duration. These data give grounds to suppose, that chronic heroin exposure impairs planning functions of prefrontal cortex (TLT), that can be explained by cumulative neuronal damages of prefrontal cortex and VTA dopamine neurons. That was demonstrated in experimental and morphological studies of opiate addicts who died after opiate overdose. Large doses of heroin can induce more extensive functional impairment with possible involvement of orbit frontal cortex. The latter deficit may be partially reversible during short-term withdrawal.
Abstract: The levels of autoantibodies and their anti-idiotypes to proteins of nervous tissue (S100b, GFAP, MP65 and nerve growth factor) were studied in 85 women of 18-48 years of age with psychogenic neurotic depressions. It was found that the changes of the levels of autoantibodies to the proteins of nervous tissue correspond to various somatoautonomic manifestations and correlate with severity of depression, its typological variations and duration of the disease. The data obtained show a close relationship between nervous and immune systems that was expressed by some parallelism of the dynamics of the changes of both neurotic depressive symptoms and serum immunoreactivity to neuroantigens.
